Re-evaluating Solid Oral Dosage Forms in Pharmaceutical Science: Patient-centric Challenges and Liquid Dosage Alternatives

Abstract

Oral drug delivery is the most widely used route of drug administration due to its convenience, safety, and high patient acceptance. Among these, solid oral dosage forms (SODF), such as tablets and capsules, remain the cornerstone of pharmaceutical therapy because of their stability, ease of manufacturing, and accurate dosing. However, despite these advantages, SODF have several limitations that may negatively affect patient adherence and therapeutic outcomes. One of the most common challenges is pill dysphagia, or difficulty in swallowing, which affects a significant portion of the population and is particularly prevalent among paediatric and geriatric patients. Dysphagia may arise from physiological factors, disease-specific conditions affecting the swallowing mechanism, or drug-induced oesophageal irritation. In addition to these physical barriers, psychological factors such as pill aversion, fear of choking, and anxiety associated with medication intake can further contribute to medication non-compliance. Practical factors including large tablet size, fixed dosage strengths, and the need for dose titration may also lead patients to split or crush tablets, potentially compromising dosing accuracy and drug release characteristics. Furthermore, administration of SODF in patients requiring enteral feeding tubes is challenging due to the risk of tube blockage and altered drug delivery. This review critically examines the various physiological, psychological, and practical challenges associated with conventional solid oral dosage forms and highlights the advantages of oral liquid formulations as a patient-centric alternative. Liquid dosage forms offer improved swallowability, flexible dosing, and suitability for enteral administration, thereby supporting better medication adherence and therapeutic outcomes, particularly in paediatric and geriatric populations.